Project Summary/Abstract Drug-related morbidity and mortality is common, with an estimated 100,000 deaths annually and a quarter of drug-related injuries being preventable. Medication errors are estimated to cause one of every 131 deaths in the outpatient setting. Many of the harmful effects of medications are preventable, particularly in the senior population. Previous research indicates that inappropriate medication use occurs in up to 40% of seniors living in the community and that inappropriate use increases as the number of medications used increases. Pharmacists have a vital role in educating patients about medications and reviewing prescription records to help determine whether or not medications are appropriate. They are able to assist patients in creating strategies to take their prescribed medications appropriately. Unfortunately, some patients may have inadequate opportunities to discuss their medications with a pharmacist for various reasons including limited access to transportation. The Meals on Wheels program provides nutritional support to seniors as well as those persons with disabilities under age 60 which allows them to remain independent at home. Meals on Wheels is the bridge between these patients and the community-they are a trusted gateway to other services. We therefore propose an innovative collaboration with Meals on Wheels to reach a population at high-risk for preventable harm from medications, specifically seniors and persons with disabilities under age 60. The broad hypothesis of this proposal is that adding medication education and counseling by a pharmacist to a Meals on Wheels program will decrease preventable harm from medications. We will determine the types of drug-related problems and assess root causes as well as quantify the number of patients at high-risk for preventable harm. The primary comparative analysis will involve a comparison of medication adherence before and after provision of medication education and counseling by a pharmacist utilizing a validated medication adherence scale and pill counts. We will also assess whether pharmacist interventions improve patient satisfaction and health status. This project will provide essential insight into the feasibility and effectiveness of teaming pharmacy services with Meals on Wheels to prevent harm from medications in those patients who are among the most vulnerable to preventable harm from medications.